Patient presents to the ER from PRTF twice in the same day after boarding for an extended period of time due to aggression towards staff. She has since been discharged from the PRTF as they felt a higher level of care was indicated. She is currently doing well here with intermittent verbal escalations though does struggle with peer relationships. She does express visual and auditory hallucinations though these do appear to be related to trauma.
Psychiatric Diagnosis: Comorbid Developmental
Comorbid developmental conditions refer to the co-occurrence of developmental disorders, which can present challenges in diagnosis and intervention.
CH-F16-3722
Patient has a history of DMDD, PTSD, ADHD, intellectual disability with FSIQ of 50, TBI, as well as seizures and psychogenic non epileptiform seizures who presents from group home where she has been aggressive and threatening to staff and other house mates. She attacked another resident there. This resident is pursuing legal charges. The patient continues to describe intent to harm other residents and staff if she goes back there, as she wants a different group home. The group home has given letter of termination and suspension. Hennepin County is patient’s guardian. County is looking into previous respite home she was at as an option, as she did really well there prior to coming to this group home 1 month ago. This same situation occurred with the same group home last fall where they terminated her and brought her to the ER.
AH-M16-2983
This child has a history of chaotic/unstable social/living situation. There is a long history of CPS involvement including being removed from his home living environment. There has historically been concerns for medical neglect (mother refusing to consent to treatment/medications, poor/lack of outpatient follow-up) and physical abuse. In recent months he has spent time between living with his mother in Minnesota and his father in North Dakota (parents are divorced). Parental rights were recently terminated and as of ~1 week ago is now under the legal guardianship of Hennepin/County/Sarah Conway (he was reportedly recently physically assaulted by mother). There is a history of trauma with maladaptive coping including chronic suicidal ideation with significant history of self-injury and/or suicidal threats. There is also a history of endorsing auditory command hallucinations of a male or female voice telling him to harm/kill himself. It has previously been noted that he copes with stress/frustration/emotion by acting out/harming self and running away.
Patient is not recommended for inpatient mental health and needs support in establishing safe placement in the community.
MCR-M16-382
Update 7/27 Genesis Group Homes is pursuing an intake to potentially utilize crisis services.
16 year old adopted from Ecuador at age 8 (with twin brother with similar difficulties, as well as 2 other siblings without similar struggles), with ASD and intellectual disability, associated with a microduplication at chromosome 8p23.1, likely in-utero substance exposure, as well as early life neglect (living in an orphanage for much of his young life). Significant aggression difficulties that are becoming more unmanageable by family as he grows larger; unsuccessfully discharged from Chileda in November 2022. Family have financial resources and have purchased a second home for the boys and hired private caregivers in the evenings, but their income limits eligibility for MA and state-funded services. New behavior analyst started working with the family in March. May be on the MSOCS wait list. Currently on the wait list for inpatient care at Kennedy Krieger near Baltimore (brother previously had a good experience there).
MCR-M17-283
State of MN is trying to find a way to build his own home, timing TBD.
Aggressive, DD, low IQ – 40-50, FAS, ward of state, targeted case mgr. Was provisionally discharged from CABHH, not allowed to return. Perhaps a plan is a state run group home, in development?